[Primary chemotherapy combining vincristine, bleomycin, methotrexate and cisplatin systemically or intra-arterially in cancers of the upper respiratory and digestive tracts].

85 patients with tumors of the upper respiratory/digestive tract were treated during an initial stage by polychemotherapy associating Vincristine, Bleomycin, Methotrexate and Cis-platinum. Administration was either by a systemic route (two cycles at a ten-day interval) or by a combination intra-arterial and intra-venous route (18-day protocol). Complete regression or regression greater than 50% of tumor volume was observed with the combination route in 76.5% of cases versus only 56.5% with use of the systemic route. In contrast, the percentage of lymph node regressions was less than 30%. No serious toxicity was observed and the classical treatment by radiotherapy for curative purposes (51 cases) or by surgery alone or associated with postoperative irradiation (30 cases) was then able to be completed without any complications linked to this initial treatment. The probability of survival, evaluated by the Log Rank Test, was significantly longer for patients who showed a positive response to initial chemotherapy.